Background The continuing social participation of older people through informal caring of family members and friends provides an important economic and social contribution to society. Participation in leisure activities and supportive social ties have been associated with improved physical and mental health. These health effects work through a number of pathways, both behavioural and psychological, which can result in better health behaviours, and buffering of the harmful effects of stress. We investigated and compared the prevalence of the provision of informal caring by the older population in Ireland and England. We investigated predictors of, and health outcomes associated with informal caring and determined whether these are moderated by social participation and receipt of formal care services and support in two different social care systems.
Methods We examined measures of physical function (hand-grip strength), mental health (CES-D, CASP-12), economic and social participation, associated with provision of informal care, using multivariate models, in the Irish Longitudinal Study on Ageing (TILDA) (Wave 3, 2014, n=6,649), and the English Longitudinal Study of Ageing (ELSA) (Wave 6, 2012–2013, n=10,372). Caring was defined as having provided care for at least one hour: in the last month, the last week and the numbers of hours of care.
Results A higher proportion of the population aged 50 and over reported caring in the last month in England (22.3%) compared to Ireland (8.9%). Caring was associated with similar characteristics (younger age, female, not employed and being married). There were similar health outcomes for both countries. The health outcomes associated with providing low intensity caring (<20 hours/week) were higher grip strength (ELSA β=1.12 (95% CI 0.63, 1.61) p<0.001), higher quality of life (TILDA β=1.23 (95% CI 0.44, 2.03) p=0.002; ELSA β=0.38 (95% CI −0.01, 0.78) p=0.056) and lower depressive symptoms (ELSA β=−0.11 (95% CI −20, −0.03) p=0.007). In contrast, intensive provision of care (50+hours/week), was associated with lower quality of life (ELSA β=−1.57 (95% CI −2.19, −0.95), p<0.001) and more depressive symptoms (TILDA B=1.02 (95% 0.24, 1.80) p=0.01; ELSA B=0.27 (95% CI 0.14, 0.41) p<0.001). These associations were moderated by active social activities, positive social relationships and access to formal care services (p=0.05).
Conclusion Across two separate social care systems, the older population contribute substantially to the support and informal care of their family and friends. Overall, informal caring was associated with positive health outcomes, but this depended on both intensity of care provided and accessibility to both social supports and formal care provision.
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